Aphasia severity is modulated by race and lesion size in chronic survivors: A retrospective study

Gadson, Davetrina S.; Wesley, Deliya B.; Stelt, Candace M. van der; Lacey, Elizabeth P.; DeMarco, Andrew T.; Snider, Sarah F.; Turkeltaub, Peter E.

doi:10.1016/j.jcomdis.2022.106270

Cited by 8 publications

(2 citation statements)

References 24 publications

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“…One explanation may be associated with how critical outcome variables moderate each other resulting in observed disparities in outcomes. A recent study found severity of aphasia to be moderated by race within larger strokes with Black Americans experiencing more severe aphasia than White Americans at similar lesion size (Gadson et al, 2022). To date, studies have been very inconsistent in reporting the racial backgrounds of participants thereby limiting some aspects of interpretation.…”

Section: Social Determinants Of Health and Aphasia Outcomesmentioning

confidence: 99%

The Intersection of Social Determinants of Health and Post-stroke Aphasia Outcomes: A Need for Intersectional Analysis

Evans,

Jacobs,

Ellis

2023

Semin Speech Lang

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Aphasia is a disorder that results from damage to portions of the brain that are responsible for language and can vary significantly by type and severity. Differences in aphasia outcomes are influenced by the social determinants of health (SDOH). The SDOH are structural, environmental, and personal determinants that influence health outcomes. Intersectionality, or how one's social and political identities interact to influence individual life outcomes and/or advantage in our society, provides a way to examine the varying levels of the SDOH. However, intersectionality is complex, difficult to measure, and has not yet been explored in post-stroke aphasia outcomes. This article reviews the relationship of race and aphasia outcomes and the SDOH and aphasia outcomes. Additionally, we provide a novel current approach to examine the SDOH and aphasia outcomes. Lastly, we discuss the need for evaluation of intersectionality in aphasia and aim to provide a leveled social–ecological framework to examine aphasia-related outcomes. With notable individual differences among aphasia outcomes, we present a framework to support optimizing research and clinical aphasia care in speech-language pathology.

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Section: Social Determinants Of Health and Aphasia Outcomesmentioning

confidence: 99%

The Intersection of Social Determinants of Health and Post-stroke Aphasia Outcomes: A Need for Intersectional Analysis

Evans,

Jacobs,

Ellis

2023

Semin Speech Lang

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“…For example, Black PWA demonstrate worse word fluency and auditory comprehension compared to their White counterparts [ 4 ]. Additionally, race appears to mediate the relationship between lesion size and aphasia impairment at larger lesion sizes [ 15 ]. Furthermore, income and education have been associated with acute aphasia impairment along with life participation in PWA one-year post-onset [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Exploring the association between social determinants and aphasia impairment: A retrospective data integration approach

Jacobs,

Evans,

Ellis

2024

PLoS ONE

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Introduction Traditionally, the study of aphasia focused on brain trauma, clinical biomarkers, and cognitive processes, rarely considering the social determinants of health. This study evaluates the relationship between aphasia impairment and demographic, socioeconomic, and contextual determinants among people with aphasia (PWA). Methods PWA indexed within AphasiaBank—a database populated by multiple clinical aphasiology centers with standardized protocols characterizing language, neuropsychological functioning, and demographic information—were matched with respondents in the Medical Expenditure Panel Survey based on response year, age, sex, race, ethnicity, time post stroke, and mental health status. Generalized log-linear regression models with bootstrapped standard errors evaluated the association between scores on the Western Aphasia Battery-Revised Aphasia Quotient (WAB-R AQ) and demographic, economic, and contextual characteristics accounting for clustering of respondents and the stratification of data collection. Region, age, and income specific models tested the sensitivity of results. Results PWA over age 60 had 2.4% (SE = 0.020) lower WAB-R AQ scores compared with younger PWA. Compared to White PWA, Black and Hispanic PWA had 4.7% (SE = 0.03) and 0.81% (SE = 0.06) lower WAB-R AQ scores, respectively, as did those and living in the Southern US (-2.2%, SE = 0.03) even after controlling for age, family size, and aphasia type. Those living in larger families (β = 0.005, SE = 0.008), with income over $30,000 (β = 0.017, SE = 0.022), and a college degree (β = 0.030, SE = 0.035) had higher WAB-R AQ relative to their counterparts. Region-specific models showed that racial differences were only significant in the South and Midwest, while ethnic differences are only significant in the West. Sex differences only appeared in age-specific models. Racial and ethnic differences were not significant in the high-income group regression. Conclusion These findings support evidence that circumstances in which individuals live, work, and age are significantly associated with their health outcomes including aphasia impairment.

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Methodologies for task-fMRI based prognostic biomarkers in response to aphasia treatment

Song,

Krishnamurthy,

Rodriguez

et al. 2023

Behavioural Brain Research

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Aphasia severity is modulated by race and lesion size in chronic survivors: A retrospective study

Cited by 8 publications

References 24 publications

The Intersection of Social Determinants of Health and Post-stroke Aphasia Outcomes: A Need for Intersectional Analysis

The Intersection of Social Determinants of Health and Post-stroke Aphasia Outcomes: A Need for Intersectional Analysis

Exploring the association between social determinants and aphasia impairment: A retrospective data integration approach

Methodologies for task-fMRI based prognostic biomarkers in response to aphasia treatment

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